{% extends "commons/layout.html" %}
{% block css %}
<link rel="stylesheet" href="/css/factory_entry_confirm.css">
{% endblock %}
{% block content %}
<div class="wrapper">
    <div class="title">工厂入驻</div>
    <div class="form">
        <div class="form-header">
            <label for="">
                {% if type == "COMMON" %}
                    <input checked=""  name="type" value="COMMON" type="radio"> <span>普通工厂</span>
                {% else %}
                    <input  name="type" value="COMMON" type="radio"> <span>普通工厂</span>
                {% endif %}
            </label>
            <label for="">
                {% if type == "GOLD" %}
                    <input checked=""   name="type" value="GOLD" type="radio"> <span>金牌工厂</span>
                {% else %}
                    <input   name="type" value="GOLD" type="radio"> <span>金牌工厂</span>
                {% endif %}
            </label>
            <label for="">
                {% if type == "DIAMOND" %}
                    <input checked="" name="type" value="DIAMOND" type="radio"> <span>钻石工厂</span>
                {% else %}
                    <input name="type" value="DIAMOND" type="radio"> <span>钻石工厂</span>
                {% endif %}
            </label>
        </div>
        <div class="form-content">
            <div class="form-group">
                <div class="label">企业名称：</div>
                <div class="form-group-input">
                    <input id="name" type="text" class="form-control">
                    <span class="error-message"></span>
                </div>
            </div>
            <div class="form-group">
                <div class="label">所在地区：</div>
                <div class="form-group-input">
                    <select name="" id="province" class="form-select-control">
                        <option value="">省</option>
                    </select>
                    <select name="" id="city" class="form-select-control">
                        <option value="">市</option>
                    </select>
                    <select name="" id="area" class="form-select-control">
                        <option value="">区</option>
                    </select>
                    <span class="error-message"></span>
                </div>
            </div>
            <div class="form-group">
                <div class="label">详细地址：</div>
                <div class="form-group-input">
                    <textarea name="" id="address" cols="30" rows="10" class="address-detail"></textarea>
                    <span class="error-message"></span>
                </div>
            </div>
            <div class="form-group">
                <div class="label">联系人：</div>
                <div class="form-group-input">
                    <input id="contactName" type="text" class="form-control">
                    <span class="error-message"></span>
                </div>
            </div>
            <div class="form-group">
                <div class="label">电话号码：</div>
                <div class="form-group-input">
                    <input id="contactPhone" type="text" class="form-control phone">
                    <span class="error-message"></span>
                </div>
            </div>
        </div>
        <div class="btn-group">
            <button class="shangqiao-btn btn btn-left">咨询客服</button>
            <button id="submit" class="btn btn-right">立即入驻</button>
        </div>
    </div>
</div>
<script type="text/javascript" src="/vendor/jquery/dist/jquery.min.js"></script>
<script type="text/javascript" src="/js/factory_entry_confirm.js"></script>
{% include "commons/shangqiao.html" %}
{% endblock %}